血清PSA联合PSAD检测对前列腺癌的诊断价值

目的:探讨血清前列腺特异抗原（PSA）、前列腺特异抗原密度（PSAD）对前列腺癌的诊断价值。方法:检测经病理确诊的57例前列腺癌、125例前列腺增生患者的血清PSA。经直肠超声测定其前列腺的体积（PV）并计算PSAD。结果:前列腺癌组患者的PSA、PSAD明显高于前列腺增生组(P<0.05)。PSA值在4.1-10.0，10.1-20.0，>20.0ng/ml区间时PCa诊断率分别为8.8%，36.8%，54.4%。前列腺癌组的ROC曲线图中PSAD的AUC值（0.682）高于PSA的AUC值（0.601），当取PSAD≥0.18ng/（ml·cm3）时，敏感性为84.5%，特异性为78.6%。比较58例重复穿刺患者的PSA、PSAD，只有PSAD差异有统计学意义(P<0.05)。结论:PSA动态监测结合PSAD是重复穿刺的重要参考指标，PSAD是PSA对前列腺癌诊断的有益补充。

The correlation between serum PSA combined PSAD and prostate diseases

Objective：To explore the performance of the prostate specific antigen （PSA） and the PSA density（PS- AD） in prostate cancer. Methods：All 182 patients （57 prostate cancer, 125 benign prostatic hyperplasia） were evalu- ated on serum PSA, and prostate volume （PV）. Results： PSA, PSAD in patients with prostate cancer were obviously higher than that of prostatic hyperplasia group（ P 〈 0.05 ）. In the PSA ranges of 4.1 -10.0,10.1 - 20.0, 〉 20.0ng/ ml, PCa diagnosis rates were 8.8 %, 36.8 % ,54.4%. In the prostate cancer group, the ROC curve of PSAD AUC val- ue（0.682） was higher than that of PSA AUC value （0.601 ） , when take PSAD at a cutoff of 0.18, sensitivity was 84.5%, specificity was 78.6%. To compare the PSA, PSAD of 58 patients with repeated puncture, only PSAD difference was statistically signifieant（P 〈 0.05 ）. Condusion： PSA dynamic monitoring in combination with the PS- AD is an important reference index,PSAD is a good complement with PSA in prostate cancer diagnosis.